University News

Dr. Goldmon Discusses Health Disparities in N&O

April 2, 2012 – If Sue Lynn Ledford were a doctor, Wake County would be her patient. As director of Wake County Human Service’s Public Health Division, she has seen the data on health disparities between white and black residents, men and women, and across age groups in various maladies plaguing the county.

So she’s sounding a community call to action that began late last year, making the rounds of community meetings and special interest groups, seeking to use neighborhood resources and word-of-mouth to close disparity gaps like a doctor writing a countywide prescription.

“We can take a targeted effort and make a fast turnaround,” Ledford told the Raleigh Citizens Advisory Council last week.

Using the Winnable Battles model from the Centers for Disease Control and Prevention, Ledford hopes to close the gap on issues such as obesity – more prevalent among men and nonwhites – and diabetes, which sees a similar trend.

Lack of access to health care is the basis of many other problems; significantly more respondents of nonwhite descent reported having no health insurance, according to the N.C. State Center for Health Statistics.

To Moses Goldmon, interim director of Shaw University’s Institute for Health, Social and Community Research, the root of health disparities is also socioeconomic. Wealth and opportunity gaps lead to education inequality, Goldmon believes, and lack of education tends to mean less access to health care.

Shaw’s program has received multiple grants to promote awareness and access to online health information. Goldmon said enlisting help from the community is important, but can be difficult.

“The challenging part becomes how to bring all the stakeholders to the table and facilitate dialogue that is constructive, when you have so many viewpoints on what the issues are,” Goldmon said.

One of Shaw’s community partners is the Central Citizens Advisory Council. From October 2011 through this September, they are training community members to find free, reliable health information online, with help from the City of Raleigh’s Digital Connectors program for teens.

As both CAC chair and program participant, Frances Lonnette Williams says she has seen the impact of such targeted health programs. In a community whose culture includes a lot of high-fat home cooking, education on its pitfalls has been helpful, Williams said.

“A lot of people like myself really didn’t understand about diabetes prevention – there wasn’t a lot available to us,” Williams said. “A lot of this has to do with prevention, things you can do to stop health problems from happening if you know about it.”

Ledford believes a targeted, evidence-based campaign over five years in Wake County could lead to marked improvement in health disparity trends. In Wake County, Ledford’s plan is to partner with existing community groups, so the resources of the Public Health Division can be put behind programs tailored for the community they’re targeting.

In the Winnable Battles model, a variety of groups within a community agree to assume specific responsibilities and focus on different areas of concern, she said.

Ledford’s focus for this year, however, is on sexually transmitted disease and infection rates among 15- to 24-year-olds in Wake County, which are sky-high compared to other age groups, and disproportionately among black residents.

“It’s marked, and you can’t ignore that,” Ledford said.

Goldmon cautions that such statistics should be viewed in context. For example, black people may be overrepresented in public health records, because other populations may be more likely to go to a private physician for medical care, he said.

A past barrier for the Public Health Division to closing the health disparities gap was stale statistics, delayed up to two years after the health information was collected from residents. Ledford’s division hired an epidemiologist last year to validate the numbers from a variety of data sources for staff to focus on.

Armed with charts and data, Ledford stopped by the Raleigh Citizens Advisory Council meeting at the City Council Chambers downtown last Wednesday in hopes of enlisting community leaders across the city.

Her presentation was an “enlightening” look at a subject that can seem difficult to help resolve, RCAC Chairman Mark Turner said. He plans to invite the Public Health Division to the CACs’ community day celebrations in August to spread the word on the ground level.

Last month, Ledford spoke at the Strengthening the Black Family annual meeting. Her next stop is with the Wake Missionary Baptist Church Association in April.

“You want to do this in such a way that is a lot more focused and targeted, instead of putting up a billboard and hoping people drive past and see it,” Ledford said.

Originally written by Chelsea Kellner and published on March 27, 2012 in the News and Observer.